Insulin resistance?

Type 1 and LADA New to Type 1 Diabetes
1

Hi all,

New to the forum. I am hoping some of you with all your expereince can help cut through my confusion. I am trying to figure out what is wrong with me. I gained alot of weight in 4 years. And pretty much have had a difficult time loosing weight since the 6th grade. College Athlete, very active person. Yet weight loss never came easy always on teh high carb, low fat, low calorie diet with heavy exercise.

Now I am seditary, at 340 with knee problems from athletics (torn meniscus and petalla syndrome)

My endo said I had insulin resistance.

2008 my ac1 test was 6.3. Insulin 94 and FBS was 129 (doctor ordered this test)
2002 my ac1 test was 5.6 FBS 83 (I ordered and paid for this test myself) was 240 then

She prescribed Metformin and Byetta(I am not taking as I am worried about burning out the pancreas). I lost 10 pounds so far, in 5 months with out working out and watching my carbs some (meaning no more pasta, or heavy carbed meals like a bagel in the morning).

I have also had fluctuating cortisol and elevated adernals and prolactin (not high but elevated above normal)

So I am trying to do research on as much stuff as I can to get a handle on what is wrong.

Trying to figure out if my symptoms are insulin resistance or something else.

When just watching what i eat to make sure I have even amount of protein and staying away from certain foods, my BG can range anywhere from 102(starting) to 177(ending after 2 hours, 177 is a rarety it usually is back down to 130-140).

I have be extremely fatigued to the point of not being able to raise my arms up, wanting to sleep all day, night sweats, unable to focus or sit still (you know jittery thoughts going from this to that constantly getting up wanting to go eat but stop myself most of the time).

With that blood sugar range can those type of symptoms be related to that?

And other doctors want to say I am diabetic (non endo dr.s) but my endo made a point in telling me that I am not diabetic.

So who do I beleive?

My endo didn’t recommend me seeing a nutrionist or adjusting my eating but I did go and see a nuttrionist and she is saying I can eat 45-60 grams of carbs each meal. 15 each snack.

I know if I go wicked high on carbs that I will go on a roll coaster ride where I will just be craving them. I

I am really confused…And any light you can shed would be greatly appreciated.

Thanks so much :slight_smile:

Angela

2

Hi Angela,

Am sorry for what you’re going through. I’m Type 1, so can’t offer much advice regarding your meds. But, what I can share is that 45-60 carbs per meal is what’s shooting your BG high.130-140 after meals is pretty high. High BG causes the fatigue you describe & the other symptoms.

Dieticians & the ADA recommendations for diabetics is WAY too high. Many people have had success going low carb. For many people this is the only way to control their BG & avoid later complications. I’ve never known anyone on a low carb diet not to lose weight & easily. With sufficient protein, you won’t be hungry & those bingining out on carb urges soon go away. Though I’ve never had a weight problem, I was high carb junkie before being diagnosed.

An A1c over 6 is considered to be diabetic.

Are you not taking Metformin or Byetta? Any meds at all? Wasn’t sure if you meant you were not taking the Byetta or both. Taking meds is going to protect your remaining beta cells. Many Type 2s seem resistant to the idea of taking insulin, but this is exactly what can preserve & protect your beta cells, along with getting your BG under control.

Has your endo done thyroid tests, a C-peptide test & antibody tests? These will tell you a lot & determine the meds you need.

Please check out low carb sites for info & also Dr. Richard Bernstein’s book “Diabetic Solution.” He’s one of the low carb gurus & a diabetic himself. Chapters of his book are on www.diabetesincontrol.com. Scroll down to the bottom of the home page & click on “archived writers” & then on Dr. Bernstein from the drop down menu.

3

I’m glad that you found this community Angela! I hope that you will get a lot of support here!!

I am also type 1 and can’t give too much advice on the medications.

But the advice that I can give is that you should not rely on the advice of this nutritionist. They tell us ALL to eat that much. My father was diagnosed with diabetes and they tried to force him to eat MORE carbs than he was eating before he was diagnosed!!! I try to eat 30-40 per meal and eat low carb snacks (raw veggies, some nuts). I think that you will feel a lot better and have an easier time losing weight if you don’t eat all those carbs!!!

Do you have a blood sugar meter at home? Has your doctor recommended that you measure your blood sugar?

4

I might be able to help.

Insulin resistance can occur in people not yet considered diabetics; It can also occur in Type 1 or Type 2 diabetics.

It is possible to have some insulin resistance and not be considered a diabetic Generally these people are considered “Pre-diabetic”. If insulin levels in the body are abnornally high it is an indication that your body is not utilizing the hormone insulin as effectively as you should. Such people would have a nornal/close to normal Hemoglobin AIC. Pre Diabetes generally precedes Type 2 diabetes.

Insulin resistance can occur in a couple of different ways:

(1) Your body is not utilizing the hormone insulin effectively. This can have varing degrees of severity. Type 2 diabetics traditionally have this form of insulin resistance.

(2) Your body has created antibodies against the hormone insulin. This can happen to a Type 1 or 2 diabetic (Don’t confuse this with Islet cell antibodies). This is a condition I developed as a Type 1. As a result my insulin requirements went up over 30%.

5

Hi Angela, I’ve been Insulin dependend diabetic for the last 15 years…and i can say that i have had lots of experiences regarding diabetes…qould yolu believed that im currently under insulin resistance…my diabetologist told me that because im also experiencing the same dilema as you…we went to other doctors cause my doctor before was gone out of town and the doctors diagnosed me to have heart ailment because of the murmur and such test…anyway i had several test back then…but when I went to my real doctor (diabetologist) Dr. Nick Villatuya, he came up to one ocnclusion, that I am encountering insulin resistance…It’s like feeling bloated and sometimes experiencing as if you gained so much weight. he just gave me a diuretic and change my insulin…that’s it…right now im using Lantus (insulin glargine)30 units in the morning…

Its good if you suppect that you have a diabetes you probably go to a diabetologist…they know better what to do…at the firts glance of your symptoms…

regards!!!
Marivic

6

Hi Angela,

Welcome. Kevin had a lot of good information. It sounds like you do have insulin resistance. I had insulin resistance beofre it turned into type ll just a couple months ago. I was an athlete just like you and now fairly sedentary, mostly because of injuries from sports, knees are shot. And I don’t know about you but it is so hard to suck it up and do a little exercise when you are used to performing at a much higher level. And it is difficult to do exercise when your body is not what it used to be when you were athletic. So I understand that. When I was insulin resistent my A1C was at 6.2/6.3 I stayed like that for about 2 years with just diet and exercise, no meds. Then it slowly went up and finally in one shot went from 6.9 to 7.3…yikes…I was so disappointed. And my doctor started me on metformin couple months ago. My blood sugars haven’t changed, hopefully my next A1C, in December will not go up again. I’m trying to eliminate carbs…I’m doing okay with eliminating sugar, but pasta is my downfall…even though I eat some whole wheat at home when I go out i still lean towards pasta dishes. I resent that I can’t choose what I want…plus a little denial is going on I think because I don’t have any real symptoms when I’ve eaten carbs. It’s dangerous to not have the symptoms I think because it gives you a false sense of security and allows you to stay in denial.
All I know is that whether you are insulin resistent or type ll you should treat it the same…get your A1C checked every 3 months, get a home meter and test at home and see your nutritionist…exercise and food choices very important…my nutritionist says exercise is key, even if you can start by doing 10-20 minutes a day and increase from there to 30 min. most days.
As far as if you are insulin resistent or diabetic it depends on what guidelines your doctors use. Either way you sound like me and my levels when I had insulin resistance according to my doctor. The bad thing about insulin resistance for me was that I didn’t take it as serious as I do now that I have been diagnosed with type ll…so keep doing what your doctor and nutritionist recommend no matter what they call it. It never hurts to eat healthy and exercise.

Take care and good luck
Christine

7

Wow, thanks so much for everyone responding. It is really appreciated.

Gerri, I am on metformin 1500 a day, is all I can tolerate and even then I get really bad diaherea. The byetta I am not taking as I am worried about burning out my pancreas. I read back in 2002 a book by a diabetic type 1 doctor who survived the disease when it was new. He said that if any cure was coming for it, it would be through using live tissues of the pancreas and type 2 should be using insulin, instead of increasing pancreas production.

The endo did a thryoid said it was normal. And the C-peptide and antibody she hasn’t ordered, what do those do? To tell you the truth I don’t think my endo is giving me proper treatment. I think she has too many patients.

She has not yet ordered a 2 hour gluclose test and it has been since May. Not sure what to do.

Thanks for the website resource I been looking at it since your post.

Hi Kristin,

Yep that is what I am using. When I told my symptoms to my endo she told me my bG was going low. I told her no it wasn’t it was still higher than normal. She was surprised to hear I was already testing myself.

I have diabetes in the family. Birth Mother’s Mother Type I not overweight. Birth Father’s Mother Type 2 400+ pounds when she died in her 70s. I say birth cause I am adopted.

I read some where that you should check your meter against a fasting glucose test at the lab to make sure it is accurate should I do this?

Hi Kevin,

Thanks for the info :slight_smile:

So you are producing insulin but your body is producing something else that is shutting it down sorta liek an autoimmune disease. You body is attacking your own natural process?

hey Marivic,

What is a diabologist? Is that an Endrocinologist?

Thanks again to everyone who replied :slight_smile:

Angela

8

Hi Christine,

I know what you are saying about exercise, I can’t even use a recumbent bike for 10 minutes with out injurying my knee with the meniscus tear.

It is tought to change the mind set of okay no 2 hour work out. It is a 30 minute light work out. No pushing yourself. Cause that is the game you play when you work out. See how long, how hard, how fast and how much you can take. I always played against the clock and pushing my body. It made time go fast when you are working out.

Now it is light, feel how bad your body feels and what it can’t do and watch time go slow as there is no game to play anymore.

Right now I am in Physical therapy for my knees, and I just injured it this week doing the recoumbent bike for 10 minutes with no resistance. Now I am walking with a cain becasue I can’t straighten it.

Working out has always made me feel better physically and mentally and I really wonder how long my insulin levels have been off.

My problem has and always has been sweets. And what I realized before I was diagnosed with insulin resistances is that sweets for me begots cravings for sweets and slugishness.

If I can stay away from them I am fine. But usually that time of the month can have me craving and then it is a vicious cycle to get out of.

I have had my endocronoligist and primary care recommend gastro by pass for the weight loss, the cortisol and insulin levels. My endo said they don’t know why but this surgery will make people who are type 2 make them no longer type 2 diabetic and cortisol levels go back to normal.

Thanks for writing,

Angela

9

Hi Angela,

I hear ya on your endo. I fired my first one because I wasn’t getting the proper care. Made all the difference in the world having one who takes time with me & knows what he’s doing. Ridiculous that you’ve been waiting this long for a test! Though with your A1c, a glucose tolerance isn’t going to show much that you don’t already know.

Good for you for taking charge & testing yourself!

Get another endo. Hate for you to be going through what you are without the right care.

The C-peptide test will show how much insulin you’re producing–very helpful for diagnosis & proper treatment. If you’re producing a normal amount, but your body isn’t utilizing it then you’re insulin resistant. If you’re really not producing much at all, then other treatment is needed–possibly some insulin. From everything I’ve read here about Type 2 meds & their side effects, insulin is a lot easier. Well, nothing is easy with our condition, but at least
insulin helps protect your beta cells & will give you control. You may just need basal insulin in the morning & at bed to keep you level. What are your morning fasting numbers? Ideal is under 100, but not too low.

The antibody test shows if you’ve got antibodies attacking your pancreas. The auto-immune situation us Type 1s have. This will also determine what’s needed in the way of treatment.

Keep us posted.

10

Might be worth reading this article in the New England Journal of Medicine… Weight Loss with a Low-Carbohydrate, Mediterranean, or Low-Fat Diet

“The mean weight loss was 2.9 kg for the low-fat group, 4.4 kg for the Mediterranean-diet group, and 4.7 kg for the low-carbohydrate group…”

Note the first two diets were calorie restricted. The low-carbohydrate diet was not calorie restricted.

11

I am concerned #2 may be happening to me… been seeing lately an increase in my insulin needs. I am working to start loosing some weight to try to help it.

12

I am a T2 diabetic since 18 I use a pump and I became insulin resistant because of my body started not to use the insulin properly. I was using 200 units a day. My pancreas is crapped out and only makes a micro dot of insulin. They switched me to u500 insulin in my pump to deal with my resistance. And yep it can make you gain weight no matter how active. You hold on to more of the fat you eat because you typically use more insulin to fight the rising blood sugars because of the resistance. Then you raise your insulin and it becomes a viscous cycle. It sucks. But the u500 is suppose to help with this.

13

Have you cosidered asking your doctor about running a test on your thyroid? Some of your symtoms sounds like the ones I had before I knew what was wrong.I had gained some weight then lost alot.I hope you can get the answers your looking for.

14

Hi Manny -

I entered the great diabetic “vicious cycle” - insulin resistant to begin with > started insulin > gained weight > insulin resistance increased > more insulin…on and on

For me, fluctuations in insulin resistance are extremely tied to weight. Every single pound increases resistance, which in turn increases insulin needs.

So, for me, both Symlin and weight training is helping. First, Symlin reduces insulin needs, and weight training reduces resistance.

15

Weight training will do the trick in terms of insulin resistance.

The only way I know to manage cravings is low carb - and it will lower A1c

Lot of good information here - http://www.phlaunt.com/diabetes/

16

Lantus can increase resistance and weight. Also, I take my Lantus in 2 separate doses - morning and night - as 1 shot doesn’t last 24 hours even though it says it does.

It’s ALL connected - weight, insulin, carbs

Research and taking control of your disease, finding what works for you - this is what has “saved my life”

Good start for research - http://www.phlaunt.com/diabetes/

17

I just read this article about a study on mice of course: “Antioxidants May Raise (type 2) Diabetes Risk: Study”
I thought it was interesting:

“Our study suggest that antioxidants may contribute to early development of insulin resistance, a pathological hallmark of type 2 diabetes”

18

Hi Angela-

I’m a T2 - over 15 years - just started insulin in January 09.

I’m not going to get in to all the detail now because it would take longer than I have right now - BUT - Angela, you should know right now that there are very different schools of thought. Many of the principals and guidelines that Josee just laid out are TOTALLY different from my own beliefs, knowledge, and personal experience.

Bottom line - keep asking questions - keep learning - then make up your own mind and find out what works best for you. Realize that you will need to be your own Diabetes Educator - especially when it comes to nutrition and diabetes. You said that you were doing a lot of research - good for you!

For now, the very best advice I can give is to start here - http://www.phlaunt.com/diabetes/
Over time, her information (IMHO) has turned out to be the most helpful, and most accurate.

A few quick points - I have found low carb (with plenty of protein and good fats, less than 40 g carb per day) to be the only way to control my BG. There’s plenty of solid science to explain why low carb/high protein/good fat WILL NOT damage your kidneys. It’s bunk that carb overload from “whole grains” is healthy for a diabetic. To determine whether Byetta or Symlin are best, you need to have a C Peptide test to see how your beta cells are faring. High BG can cause lots of short term issues, like extreme fatigue, as well as long-term issues, like permanent organ damage. Night sweats could be Dawn Phenomenon - your after food numbers aren’t that bad but your FBS is too high - it may be that you need long-acting insulin to cover times when you are not eating (like sleeping or between meals)

Back to work! Hope this helps.

Cheri

19

Excellent article John, and all dieticians, nutritionists and others in the medical profession should be forced to read it.

A reduced cab diet is the only way forward for most non insulin dependent T2 Diabetics.

20

Hi Angela.

Unexplained weight gain is one of the major symptoms of T2 Diabetes and is not often emphasised by Diabetes professionals.

As people here have said diet and exercise are the key.

If you have joint problems you could opt for low impact exercises such as using a rowing machine, swimming, yoga and tai chi.

Have you asked your doctor if you could go on a sulfonylurea as an alternative to Metformin?

It is said that some doctors avoid them in favour of Metformin because of the risk of hypos but I’ve never had any problem with them.

Frank